By PPH Foundation
Armed conflict does not only disrupt daily life, it systematically dismantles the health systems that protect mothers during childbirth. When hospitals, maternity wards, and blood banks are damaged or destroyed during war, the ability to manage obstetric emergencies such as postpartum haemorrhage (PPH) rapidly deteriorates.
PPH, the excessive bleeding after childbirth, remains the leading cause of maternal deaths globally. In normal conditions, it can often be prevented or managed through timely interventions such as uterotonic drugs, blood transfusion, and skilled obstetric care. However, in war zones these lifesaving interventions become difficult or impossible to deliver.
Research published in the journal BMC Pregnancy and Childbirth examining the conflict in Tigray, Ethiopia found that maternal outcomes worsened significantly during the war. Mortality associated with haemorrhage increased dramatically, while the use of critical obstetric interventions such as oxytocin declined due to shortages of medicines, equipment, and supplies.
The destruction of health infrastructure is often at the center of this crisis. In many conflict settings, hospitals are damaged by shelling, looting, or occupation, forcing healthcare workers to operate under siege-like conditions or abandon facilities altogether. Studies examining conflicts in Sudan and other fragile regions show that attacks on clinics and hospitals disrupt supply chains for essential medicines and obstetric equipment, leaving maternity services severely compromised.
When maternity wards are no longer functional, deliveries often shift to unsafe environments such as homes, temporary shelters, or displacement camps. Without skilled birth attendants, emergency procedures that control bleeding, including uterine massage, surgical intervention, or blood transfusion, are rarely available.
The result is a dramatic rise in preventable maternal deaths. According to the United Nations, more than 60 percent of preventable maternal deaths occur in fragile and conflict-affected countries, where health systems struggle to function under extreme pressure.
Even when some health workers remain, the absence of electricity, sterilized equipment, medicines, and blood supplies means that the tools needed to stop postpartum bleeding are simply not available. In such circumstances, a complication that would normally be treatable within minutes can quickly become fatal.
Dr Eunice Atsali, a Midwife and a Co- Lead of the End Postpartum Haemorrhage Initiative, notes that the collapse of health infrastructure during conflict directly translates into maternal deaths.
“Postpartum haemorrhage is highly treatable when the right systems are in place. But when hospitals are destroyed, supply chains are disrupted, and skilled personnel cannot reach patients, mothers lose the very protections that modern medicine provides,” she says.
Protecting healthcare facilities during armed conflict is therefore not only a humanitarian obligation, it is a lifesaving maternal health intervention. Without functioning hospitals, blood banks, and trained personnel, the fight against postpartum haemorrhage becomes almost impossible.
As global conflicts continue to rise, safeguarding maternal health services must remain a critical priority. Ensuring that hospitals remain protected spaces during war could mean the difference between life and death for thousands of mothers each year.
Sources
- Study on maternal outcomes during conflict in Tigray, Ethiopia, BMC Pregnancy and Childbirth.
- Research on the impact of conflict on maternal health systems in Sudan and fragile settings.
- Maternal mortality trends in crisis-affected countries, United Nations report on women in conflict settings.
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